Oral and Maxillofacial Surgery
What is Oral Surgery?
Oral and maxillofacial surgery is the specialty of dental practice that deals with the diagnosis and surgical treatment of diseases, injuries and defects of the mouth, jaws, face and related structures. This includes the removal of impacted and decayed teeth, placement of dental implants, biopsy and removal of cysts and tumors of the mouth and jaws, treatment of facial trauma and reconstructive jaw surgery.
What does maxillofacial mean?
Maxillofacial refers to the face and jaws, which along with the mouth comprise the areas of expertise of an oral and maxillofacial surgeon.
General Patient Information
Call our office directly – 609-877-2030. No referral from a dentist or physician is necessary. Office hours are by appointment from 8:00 AM to 3:00 PM, Monday, Tuesday, Thursday and Friday. Every effort is made to see emergencies immediately. We pride ourselves in seeing you at your appointed time.
A complete medical history is necessary for every patient of record. Please bring all pertinent medical information to your appointment. Any insurance information is also necessary. Call us if you have any questions.
A panoramic radiograph that shows your full jaw is usually necessary for oral surgery. If your dentist has taken x-rays in the past six to twelve months, they may be adequate, but we often need additional films to properly evaluate you and provide care.
Sedation (Twilight Sleep)
If you want to be sedated for your procedure, you must have nothing to eat or drink, (not even water), for at least six hours beforehand. A responsible adult must be with you to drive you home. Please wear short sleeves so that your blood pressure can be taken, and bring a case if you wear contacts. Prescription medications should be taken with a sip of water. A parent or guardian must accompany children under 18 even if local anesthesia is planned.
We process most insurance plans, but please confirm your coverage with us. Most insurance plans pay a portion of your bill. The non-covered co-payment and deductible amount are expected on the day of your procedure. We file claims promptly, and we serve as your advocate.
We are happy to provide you with a pre-surgical estimate of fees. Payment is expected on the day of service unless other arrangements have been made in advance. We accept Visa, MasterCard, Discover and American Express. Payment plans can also be arranged through CareCredit Please talk with our business manager for more details prior to your procedure.
What are dental implants?
A dental implant is a titanium fixture that is implanted in the jaw. It can replace a single tooth or it can be a support for a bridge or a denture.
Who is a candidate for dental implants?
Anyone in reasonable health who wants to replace missing teeth can be considered as a candidate. You must have enough bone in the area of the missing teeth to provide adequate anchorage for the implants. Most people today are potential candidates for dental implants to replace a single missing tooth, small bridges or removable partial and full dentures.
What is the success rate of dental implants?
This depends on where the implants are placed and their function, as well as how well they are cleaned at home after they are completed. Most studies show success rates of at least 90%.
Why are dental implants so popular?
Implants offer tooth replacements that attach to the jaw and can have many advantages over conventional methods. They are both functional and aesthetic.
Does it hurt to have dental implants placed?
Most people experience minimal discomfort following dental implant placement. Most describe the implant as less painful afterward than having a tooth extracted. The procedure can be done either under local anesthetic or intravenous sedation.
While the implants are bonding to my jawbone, do I have to go without my “teeth”?
In most instances, temporary teeth can be worn during the healing period. On occasion, it will be recommended that a patient go without any temporary teeth for a short period of time.
Pre Operative Instructions Before Sedation
- Nothing to eat or drink (including water) for six (6) hours prior to the appointment.
- No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
- The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
- Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
- Contact lenses, jewelry, and dentures must be removed at the time of surgery.
- Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
- If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
- If you take routine oral medications, please check with Dr. Focarile prior to your surgery.
Post Operative Instructions After Oral Surgery Procedures
Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened, squeeze dried tea bag for sixty minutes, repeat as necessary. The tannic acid in the dry tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
For moderate pain – Motrin 200 mg, 2 pills every 4-6 hours or Aleve (Naproxen Sodium) 225mg, 2 pills every 8-12 hours.
For severe pain, take the narcotic prescribed as directed. The narcotic pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
After general anesthetic or I.V. sedation, liquids should be initially taken. We recommend any sports drink once the numbness wears off. Once the numbness wears off, do not use straws; drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Keep the mouth clean
No rinsing or spitting of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery, but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least one hour, including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine, but stop the narcotic pain medication.
We accept most insurance plans and offer CareCredit financing. Please call
609-877-2030 for further information, or email us with questions or to schedule an appointment.
If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Dr. Focarile if you have any questions.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute, then get up.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Focarile.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event, which will resolve in time.